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CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total Fee: $ 5/'7' /5 Date Received: <br /> Date Approved: <br /> Entered By: ' <br /> Permit#: 5-1.6 <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List En • <br /> THE APPLICANT IS: (circle one) OWNER or CONTRACTOR <br /> JOB SITE ADDRESS:/19a / !r 5 is ! Fay ZIP: <br /> A ! <br /> (work) <br /> NAME OF OWNER: L,0 6 "Ne. a eC! PHONE: (home) <br /> MAILING ADDRESS: I2 12.L(/aj/?7 a B/'a CITY: 6"i a/32 f2 ZIP: -731-3`? / <br /> CONTRACTOR: D& Iq,.?/o_,/r' &f S PHONE: 6rz evv74,ow <br /> '_ 1l�,/�- TY: ZIP: 7 <br /> MAILING ADDRESS: !� �� � �����AK���� _�lQ�� � � �� <br /> STATE LICENSE: # <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> A‘71' ,/e(46 <br /> PROPOSED WORK (describe in detail) : S(�//tel�i�7 á2,/,, <br /> STORIES: SQ. FEET OF EACH FLOOR: <br /> NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. <br /> ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 3z-r, �Da <br /> I hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance with the <br /> ordinances and codes of the City and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work will be in accordance with the approved plan. <br /> 1 <br /> lQ <br /> APPLICANT'S SIGNATURE �/ DATE: ��5�/ < y <br />